Specialised Services

ENDOGENOUS LASER THERAPY (EVLT)

Endovenous Laser Treatment (EVLT) is a minimally invasive treatment method for large varicose veins. A fibre optic wire is inserted into the veins and laser energy is delivered directly into the lumen of the vein, thereby avoiding heating up skin or surrounding structures. Adequate energy can then be accurately delivered and the treated vein be heated up to allow it to shrink and disappear over time.

The procedure is done under local anesthesia, sometimes with some sedation, No hospitalization is needed. There are no incisions (except a single tiny puncture) and thus no scars. Pain is minimal. The patient can walk out of the clinic immediately and continue with normal daily activities.

Patients with very tortuous varicose veins or varicose veins which were treated incompletely previously may not be candidates for this procedure as the laser fibre may not be able to navigate through the vein.

EVLT was pioneered in the USA by Drs. Robert Min and Luis Navarro in 1999 and then gained more widespread use in the early 2000s. Dr. Nawaz carried out the first EVLT procedure in this region in 2003.

Numerous international research studies have shown that this method of treatment is superior to the conventional open surgery for varicose vein treatment. EVLT is as effective (if not, indeed, more so) in getting rid of the varicose veins than open surgery, but being so much less invasive and less painful with less complications, it has virtually replaced open surgery in most major vein centres of the world.

Endovenous Laser Therapy is also known by other names and accronyms like Endovenous Laser Ablation (EVLA), ELT or Endovenous Laser Vein Surgery (ELVeS) by various manufacturers of the laser machines.

The initial EVLT lasers were of shorter wavelengths like 810 or 980 nm. While these were successful in treating the varicose veins, there were still some side effects. Improvements in the laser technology have given us newer machines with longer wavelengths like the 1470 nm lasers and better laser fibres, radial fibres and gold-tip fibres. These have resulted in better treatment outcomes with lesser side-effects like less pain and less bruising.

Radiofrequency Ablation (RFA) is similar to EVLT in technique and process but instead of using light (laser) to heat the vein, another form of energy (radiofrequency) is used. RF technology is not new. In fact, RF was used before laser for treating varicose veins, but the initial devices fell out of favour when lasers were introduced. Newer RF devices have improved features, making the treatment results and side-effects similar to the newer laser devices.